6 things you need to know about the Tomah VA scandal
GOP blasts Baldwin, who admits staff errors
As the race between Democratic U.S. Sen. Tammy Baldwin and Republican Leah Vukmir heads to the final stretch, voters will hear a lot about the four-year-old scandal at the Tomah Veterans Affairs Medical Center.
The story bubbled beneath the surface for years but exploded into public view with a 2015 investigative series that dubbed the Tomah VA as “Candy Land” for its widespread distribution of opioids.
Republicans accuse Baldwin of sitting on her hands while veterans were being given dangerous amounts of painkillers. She acknowledged her staff erred and in the wake of the scandal pushed for reforms at the VA.
Outside groups have launched millions of dollars in ads, both attacking and supporting Baldwin. Vukmir has charged that Baldwin covered up an inspector general’s report, which the first-term senator has denied.
1. The scandal’s roots
For years, doctors at the Tomah VA were overprescribing opioids, leading to the August 2014 death of a U.S. Marine veteran, Jason Simcakoski.
The roots of the scandal went back to at least 2007 with the death of a veteran from “poly medication overdose” a day after being discharged from the Tomah facility.
In 2011, after an anonymous constituent sent complaints to federal officials and U.S. Rep. Ron Kind about Tomah’s opioid prescription practices, the VA inspector general opened a 21⁄2-year investigation into the center.
2. Baldwin involvement
Baldwin’s U.S. Senate office, meanwhile, was contacted by another whistleblower in March 2014, and Baldwin wrote Tomah’s director to raise concerns about the widespread distribution of controlled substances at the central Wisconsin facility. The director was largely dismissive of the concerns.
In June 2014, she followed up with letters to the VA’s congressional liaison service director and the agency’s Office of Inspector General calling for a review and investigation of concerns raised at Tomah. The response appeared perfunctory.
On Aug. 29, 2014, the VA’s inspector general provided Baldwin’s office a copy of an 11-page report based on its 21⁄2-year investigation. Baldwin’s office sent the report to the constituent who had raised concerns but did not make it public.
The report said particular physicians at the medical center were “prescribing an unusually high total opioid amount.”
A day later after Baldwin’s office received the report, Simcakoski died as a result of “mixed use toxicity” while being treated by doctors at the facility.
3. Whistleblower Ryan Honl
Yet another whistleblower, Ryan Honl, finally got some action — but only after running into a brick wall in late 2014 with his repeated attempts to get the offices of Baldwin, Kind and U.S. Sen. Ron Johnson to intervene at the Tomah VA over a variety of issues. Kind is a Democrat, and Johnson a Republican. Honl wasn’t the only one raising concerns. State regulatory officials acknowledged receiving an anonymous complaint against a Tomah VA doctor accusing him of “alleged overprescribing of oxycodone.” The case was opened Aug. 12, 2014. The doctor surrendered his license in January 2017.
In his dealings with Baldwin’s office, Honl said he talked repeatedly to the senator’s aides about the problems in Tomah. One of Baldwin’s aides, Marquette Baylor, discouraged him from going public with his concerns, saying that doing so might get her and others fired.
In November 2014, Honl — a Gulf War veteran and West Point graduate — asked another Baldwin aide for a copy of the inspector general’s report but didn’t immediately receive a response. Honl soon decided to take the issue to the media.
At the end of 2014, Baylor has said, she prepared three memos on the situation at Tomah for her superiors, including two that were addressed to Baldwin, among others.
Baldwin says she never got those messages.
4. Public bombshell
In January 2015, tipped off by Honl, the Center for Investigative Reporting released an explosive series of articles accusing the Tomah VA of rampant over medication of patients, retaliatory management practices and preventable overdose deaths
According to the stories, the number of opiates prescribed at the Tomah medical center more than quintupled over the past decade, despite a drop in patients.
As a result of the stories, two high-level Tomah VA employees — including then-chief of staff David J. Houlihan — were reassigned and then dismissed.
Days after the stories were published, Baldwin and Kind called for an investigation into the problems at the VA facility.
The first-term Democratic senator also fired Baylor without explanation two weeks after publication of the news stories. Ethics complaints later filed by Baylor and two outside groups against Baldwin were dismissed.
5. Baldwin’s internal review
Under intense public criticism, Baldwin hired Marc Elias, a heavy-hitting Democratic attorney who is a partner at the Perkins Coie law firm in Washington, D.C., to review why her office mishandled the complaints about the troubled Tomah facility.
Elias soon issued a statement saying Baylor had been fired for “her long-term performance on a range of issues,” not just the Tomah scandal.
His five-page report found that Baldwin’s constituent services team failed to relay concerns to the office’s top staff. From there, the report said, her senior aides took too long to formulate an “effective response” to the problems.
But Elias concluded in March 2015 that there was no cover-up by the senator’s staff or any intention to bottle up the inspector general’s report.
In response to the report, Baldwin ordered her chief of staff, Bill Murat, to take a one-time pay cut of $14,000 and demoted Doug Hill from state director to deputy director of outreach, slicing his annual pay by more than $50,000 a year.
6. Jason’s law
In June 2015, Baldwin introduced a bipartisan bill named after the deceased Marine veteran, calling it the Jason Simcakoski Memorial Opioid Safety Act, or “Jason’s Law.” President Barack Obama signed the measure in July 2016.
The law toughened opioid prescription guidelines, pushed education for VA providers and encouraged better communication among health care professionals, patients and families on pain management.
In July 2017, Baldwin and Simcakoski’s parents, Linda and Marvin Simcakoski, met at the Tomah facility, where they were briefed on the progress made in treating patient pain and fighting prescription abuse.
In a recent interview with the Milwaukee Journal Sentinel, Tomah VA Medical Center director Victoria Brahm said the facility has turned the corner.
“We’ve shown so much change from those days of the opioid crisis,” Brahm said.
“We are just forging forward because we know our veterans need us, and we know we have wonderful service for them.”